| NPI | 1326510553 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 2030)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional | 
| Enumeration Date | 2018-12-28 | 
| Last Update Date | 2021-11-02 |